By Lori Solomon, Editor, Diagnostic Testing & Emerging Technologies
Increasingly, the practice of laboratory medicine is burdened by administrative responsibilities leaving less time for research among academic clinical chemists (laboratory physicians and scientists), according to a study published in the February issue of Clinical Chemistry. A group of international laboratory medicine leaders independently answered questions regarding the evolution of the profession and the long-term implications of changing clinical service demands.
“Despite all the challenges we face, laboratory medicine physicians have to play a clear leading role in the application of emerging biomarker technologies and the management of complex laboratory structures,” responds Michael Oellerich, M.D., from George-August-University (Germany). “I am optimistic that the current pace of innovation, flood of new technologies, and advances in molecular diagnostics provide an environment in which laboratory medicine as an academic profession has a chance to grow.”
The profession though is recalibrating in the face of broader health system economic challenges, seen both in the United States and internationally. Over the past decade, the authors say, there have been significant increases in regulatory requirements, quality assessment programs, compliance issues, and general administrative responsibilities of laboratory directors that have negatively impacted the academic aspects of the profession, including the time to participate in research. Many of the interviewed experts cite laboratory automation and consolidation as driving centralization of laboratory testing, giving rise to “the risk of our profession becoming solely ‘big business’ in its underlying structure,” says Brian Smith, from Yale University (New Haven, Conn.).
“Laboratories have indeed been an easy target for economic saving owing to their ‘technological’ characteristics,'” says Mauro Panteghini, from University of Milan (Italy). “As a main consequence of the two driving processes (i.e., automation and economic pressures), cost savings have frequently been realized by consolidation … [and] also contributed to the increased perception of laboratory production as a commodity, often ignoring the importance and the true impact of diagnostic testing in the overall context of health economics.”
But, the experts are not entirely gloomy about the state of laboratory medicine practice. They uniformly marvel at the technological transformations that have reshaped testing, particularly molecular diagnostics. Consensus opinion also shows that these advancements need to be incorporated into training the next generation of laboratory scientists. Aside from technical competence, the interviewed experts stressed that future training efforts must additionally focus on informatics, greater economic and management competence, and the need for a multidisciplinary team approach as clinical laboratory results are increasingly seen as “therapeutic pathology,” driving real-time therapy decisions.
“Our technical and problem-solving skills need to go beyond the walls of the clinical laboratory; we must be active in meetings with the clinicians, regulatory staff, and administrators,” says Fred Apple, Ph.D., from University of Minnesota, Minneapolis. “One should not wait to be told what to do; the clinical chemist should become part of the solution.”